Under the Paperwork Reduction Act
red to respond
PTO7SB/06 (12-04)
Approved for use through 7/91/2006. OMB 0661-0032
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COM MERCE
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PATENT APPLICA"KQ(S5gtBerERiyilNATION RECORD
Substitute for Form PTO-875
Application or Docket Number
10/813,072
APPLICATION AS FILED - PART I
FOR
NUMBER FILED
NUMBER EXTRA
BASIC FEE
(37CFR1.t©(i),(b),ar(c))
N/A
WA
SEARCH FEE
(37 CFR 1.18(h), OX or <m))
N/A
N/A
EXAMINATION FEE
(37 CFR 1.19(0). (p).or(q))
N/A
N/A ]
TOTAL CLAIMS
(37 CFR 1.18(0)
minus 20 »
INDEPENDENT CLAIMS
(37 CFR 1.18(h))
minus 3 ■
♦
APPLICATION SIZE
FEE
(37CFR1.16(i))
If the specification and drawings exceed 100
sheets of paper, the application size fee due
is $250 ($125 for small entity) for each
additional 50 sheets or fraction thereof. See
35 U.S.C. 41(a)(1)(G) and 37 CFR 1.16(a).
MULTIPLE DEPENDENT CLAIM PRESENT (37 CFR 1.180))
' [f the difference in column 1 1s less than zero, enter "0* in column 2.
APPLICATION AS AMENDED - PART II
(Column 1)
(Column 2)
(Column 3)
*JT A
CLAIMS
REMAINING
AFTER
AMENDMENT
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
ill
5
Total
(37 CFR 1.180)}
* 31
Minus
" 11
MEND
(17 CFR 1.18(h))
* 3
Minus
" 0
Application Size Fee (37 CFR 1.16(8))
<
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.1 BQ)
(Column 1)
(Column 2)
(Column 3)
CD
CLAIMS
REMAINING
AFTER
AMENDMENT
HIGHEST
NUMBER
PREVIOUSLY
PAID FOR
PRESENT
EXTRA
Hi
Total
(»7 CFR 1.188))
*
Minus
■
MEND
Independent
(37 CFR 1.18(h))
•
Minus
***
a
Application Sis
9 Fee (37 CFR 1.16(s))
<
FIRST PRESENTATION OF MULTIPLE DEPENDENT CLAIM (37 CFR 1.16®)
SMALL ENTITY
OR
OTHER THAN
SMALL ENTITY
RATE (1)
FEE(S)
N/A
N/A
N/A
X ■
X ■
N/A
TOTAL
SMALL 1
ENTITY
RATE ($)
ADDI-
TIONAL
FEE($)
x 25. o
275.
x *
N/A
TOTAL
ADO'L FEE
275.
OR
RATE (S)
WA
TOTAL
JEEflL
OR
OR
OR
OR
OR
OTHER THAN
SMALL ENTITY
RATE ($)
N/A
TOTAL
ADO'L FEE
ADDI-
TIONAL
_FEEfiL
RATE ($)
ADDI-
TIONAL
X ■
X ■
N/A
TOTAL
ADO'L FEE
OR
OR
OR
OR
RATE ($)
TOTAL
ADD! FEE
ADDI-
TIONAL
_FEEfiL
* If the entry In column 1 1s less than the entry in column 2, write *0" In column 3.
"If the -Highest Number Previously Paid For* IN THIS SPACE is less than 20, enter *2CT.
— ff the "Highest Number Previously Paid For* IN THIS SPACE is less than 3, enter T.
The 'Hghest Number Prevtousty Paid For (Total or Irriependent) Is the highest number found In the appropriate box tn column 1.
This couectkm of information Is required by 37 CFR 1.16. The Information Is req tired to obtain or retain a benefit by the puttie which is to file (and by the
USPTO to process) an application. Confidentiality is governed by 36 U.S.C. 122 and 37 CFR 1.14. This coSection is estimated to take 12 minutes to complete,
including gathering, preparing, and submitting the completed application form to the USPTO. Time wfll vary depending upon the Individual case. Any comments
on the amount of time you require to complete this form and/or suggestions for reducing this burden, should be sent to the Chief Information Officer, U.S. Patent
and Trademark Office, U.S. Department of Commerce, P.O. Box 1450, Alexandria, VA 22313-1450. DO NOT SEND FEES OR COMPLETED FORMS TO THIS
ADDRESS. SEND TO: Commissioner for Patents. P.O. Box 1460, Alexandria. VA 22313*1460.
If you need assistance in completing the form, call 1-6QWTO-9199 and select option 2